title: Surgical treatment of active native valve endocarditis.
abstract: A report is presented of 24 patients (23 male), mean age 38 years, who underwent surgery for active native valve endocarditis of the left heart in 1975-1988. The aortic valve was affected in all patients, and also the mitral valve in five. Pre-existing aortic valve disorder was present in 17 cases (13 congenitally bicuspid 4 rheumatic affection). There were five hospital deaths (20.8%). Staphylococci as causal organism and extensive infection predicted the highest mortality and morbidity. The mean follow-up time was 39.7 (range 2-114) months. Two reoperations because of prosthetic valve dehiscence revealed endocarditis of the implanted valve. Strong correlation was found between favourable postoperative course and rapid normalization of C-reactive protein levels, which did not fall in patients with persistent infection. Early surgery is recommended if the course of bacterial endocarditis is severely complicated.
authors.affiliation: Department of Surgery, University Central Hospital, Turku, Finland.
authors.forename: M J
authors.initials: MJ
authors.lastname: Janatuinen
authors.forename: E A
authors.initials: EA
authors.lastname: Vänttinen
authors.forename: J
authors.initials: J
authors.lastname: Nikoskelainen
authors.forename: M V
authors.initials: MV
authors.lastname: Inberg
mesh_terms: D000328:Adult; D001021:Aortic Valve / Q000601:surgery; D002097:C-Reactive Protein / Q000378:metabolism; D004697:Endocarditis, Bacterial / Q000097:blood / Q000401:mortality / Q000601:surgery*; D006349:Heart Valve Diseases / Q000097:blood / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000601:surgery; D011183:Postoperative Complications; D015996:Survival Rate
chemical_list: D002097:C-Reactive Protein